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Overcrowding continues to afflict emergency departments (EDs), and its attendant consequences are becoming increasingly severe. The burden of the COVID-19 pandemic is further escalating the situation worldwide. One of the most critical questions is how to adequately quantify what constitutes overcrowding and determine implications for operations management in improving service efficiency. This paper aims to discuss the aforementioned.

The authors propose the time and class complexity measures for ED service systems, taking into account important patient-level and system characteristics. Using an extensive data set from a Canadian ED, the authors investigate the performance of complexity-based measures in predicting service delays.

The authors find that the complexity measure is potentially more important than some well-known crowding metrics. In particular, EDs can improve service efficiency by managing the level of complexity within a desirable interval. Furthermore, complexity exposes how the interplay between demand-side behavioral changes and supply-side responses affects operational performance. Moreover, the results suggest that arrival patterns—the number of patients of each class arriving per time and times between events (arrivals and service completions)—increase the risk of service delays more than the demand volume.

This paper is the first to provide an extensive investigation into the application of the complexity-based measure for ED crowding. The study demonstrates potential values to be gained in ED service systems if complexity measure is incorporated into their operations management decisions.

This research fills a gap in process science by defining and explaining entropy and the increase of entropy in processes.

This is a theoretical treatment that begins with a conceptual understanding of entropy in thermodynamics and information theory and extends it to the study of degradation and improvement in a transformation process.

A transformation process with three inputs: demand volume, throughput and product design, utilizes a system composed of processors, stores, configuration, human actors, stored data and controllers to provide a product. Elements of the system are aligned with the inputs and each other with a purpose to raise standard of living. Lack of alignment is entropy. Primary causes of increased entropy are changes in inputs and disordering of the system components. Secondary causes result from changes made to cope with the primary causes. Improvement and innovation reduce entropy by providing better alignments and new ways of aligning resources.

This is the first detailed theoretical treatment of entropy in a process science context.

This study investigates the extent to which a firm’s centrality and autonomy in its supply network are associated with the intensity and complexity of its competitive actions.

Utilizing social network analysis and dynamic panel data models, this study analyzes a comprehensive panel dataset with 10,802 firm-year observations across various industries between 2011 and 2018 to test the hypotheses.

Our findings show that a firm’s level of centrality in its supply network has an inverted U-shaped relationship with both competitive intensity and competitive complexity. In addition, the turning points of these two inverted U-shaped relationships differ in that firms with a lower level of centrality tend to compete aggressively by launching more actions within fewer categories, while firms with a higher level of centrality tend to compete aggressively by launching fewer actions that cover a larger range of categories. Finally, we find that a firm’s structural autonomy has a positive relationship with competitive complexity.

This study bridges the gap between the supply chain management literature and strategic management literature and investigates how supply networks shape competitive aggressiveness. In particular, this research investigates how a firm’s structural position in its supply network affects its competitive actions, an important intermediate mechanism for competitive advantage that has been overlooked in the supply chain management literature.

The main aim of this study is to explore the appropriate factors in measuring COVID-19-induced supply chain disruptions and the impact of these disruptions on the economic vulnerability of small-scale farmers in Sri Lanka.

The findings revealed that most of the farmers have continued to cultivate even during the pandemic despite several challenges which affected their economic status. Therefore, it is concluded that COVID-19-induced transportation and demand disruptions exacerbated the economic vulnerability of small-scale farmers over the disruptions in supply and production.

The findings of this study are crucial for formulating novel policies to improve the sustainability of the Sri Lankan agricultural sector and alleviate the poverty level of Agri-communities in the countryside. As farming is a vital sector in the economy, increased attention ought to be given on facilitating farmers with government-encouraged loans or allowances for their financial stability. Further, the respective government authorities should develop programs for importing and distributing adequate quantities of fertilizers among all the farmers at controlled prices so that they can continue their operations without any interruption. Moreover, the government could engage in collaboratively work with private organizations to streamline the Agri-input supply process. There should be a government initiative for critical consideration of the issues of farming families and their continued motivation to engage in agriculture. Thus, farmers' livelihoods and agricultural prosperity could be upgraded through alternative Agri-inputs and marketing strategies, providing financial assistance, encouraging innovative technology, etc.

Despite the significance and vulnerability of the vegetable and fruit sector in Sri Lanka, there is a limitation in the empirical studies conducted on the supply chain disruptions caused by COVID-19 measures and their implications on the farmers' livelihood. Furthermore, previous empirical research has not employed adequate quantitative tools to analyze the situation or appropriate variables in evaluating COVID-19-induced disruptions. Hence, the current study explored the appropriate factors for measuring COVID-19-induced supply chain disruption using exploratory factor analysis. Then, the impact of those factors on the economic vulnerability of the small scale farmers was revealed through the ordinal logistics regression analysis.